乌苯美司联合XEC化疗方案治疗三阴性乳腺癌的临床研究

目的探讨乌苯美司联合XEC化疗方案治疗三阴性乳腺癌患者的临床疗效及其对外周血T淋巴细胞亚群及血清骨桥蛋白(OPN)水平变化的影响。方法选取河南科技大学第一附属医院2015年6月—2017年1月收治的三阴性乳腺癌患者83例,随机分成对照组(41例)和治疗组(42例)。对照组患者给予XEC化疗方案治疗,第1天静脉滴注注射用环磷酰胺500 mg/m~2,同时静脉滴注注射用盐酸表柔比星100 mg/m~2,第1~14天口服卡培他滨片1 g/m~2,疗程为21 d。治疗组在对照组的基础上口服乌苯美司片,30 mg/次,1次/d,疗程为21 d。两组均持续治疗4个疗程。观察两组患者临床疗效,比较治疗前后两组患者SF-36评分、外周血T淋巴细胞亚群表达水平和OPN水平。结果治疗后,对照组和治疗组临床总有效率分别为75.61%、95.24%,两组比较差异具有统计学意义(P0.05)。治疗后,两组躯体疼痛、躯体功能、睡眠质量、生命活力、生理职能、心理健康等生活质量评分均显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组生活质量评分显著高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者CD~(3+)、CD~(4+)、CD~(4+)/CD~(8+)水平均显著升高,CD~(8+)水平显著下降,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组T淋巴细胞亚群水平显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清OPN水平显著下降,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组血清OPN水平显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论乌苯美司联合XEC化疗方案治疗三阴性乳腺癌患者效果显著,可有效改善患者外周血T淋巴细胞亚群和血清OPN水平,且安全性较高,具有一定的临床推广应用价值。     

超声造影TIC定量参数在乳腺癌分期早期诊断中的应用

目的探究乳腺癌患者超声造影时间-强度曲线(TIC)参数与其分子生物学标志物的相关性。方法回顾性分析109例乳腺癌患者临床资料,根据其TNM分期分为中早期组和晚期组。比较两组TIC相关参数和分子生物学标志物水平,采用ROC曲线分析TIC相关参数对乳腺癌分期的评估效能。结果晚期组TIC相对上升斜率、达峰强度、曲线下面积大于中早期组,TIC相对达峰时间短于中早期组(P＜0.05)。晚期组雌激素受体、孕激素受体、人表皮生长因子-2、增殖相关核抗原ki-67阳性表达等均高于中早期组(P＜0.05)。TIC相对上升斜率、达峰时间、达峰强度、曲线下面积评估乳腺癌TNM分期的AUC分别为0.878、0.755、0.843、0.796。结论乳腺癌患者TIC参数可有效反映乳腺癌进展情况,且其获取方式更具无创性,可为临床评估乳腺癌分期提供参考。     

ACL的构建及其对结直肠癌HCT116细胞增殖和迁移的作用

目的探讨miR-363-5p靶向三结构域蛋白14(TRIM14)对3种乳腺癌细胞系凋亡的影响。 方法采用实时荧光定量PCR法比较不同化疗药物诱导3种乳腺癌细胞(MCF-7、MDA-MB-435、MCF-12A)中miR-363-5p和TRIM14 mRNA表达水平,采用免疫组化法检测不同亚型乳腺癌组织TRIM14表达情况。采用Western blotting检测TRIM14蛋白表达。采用流式细胞术检测细胞凋亡情况。应用生物信息学方法预测miR-363-5p与TRIM14的结合位点,通过干扰miR-363-5p和TRIM14研究miR-363-5p对3种乳腺癌细胞中TRIM14的调控作用。Pearson相关分析各亚型乳腺癌组织中miR-363-5p与TRIM14的相关性。 结果3种化疗药物均能促进细胞凋亡,化疗药物处理3种亚型乳腺癌细胞后miR-363-5p表达上升,TRIM14 mRNA表达下降。荧光素酶报告基因实验发现TRIM14是miR-363-5p的靶基因。过表达miR-363-5p后,3种亚型乳腺癌细胞凋亡率上升,TRIM14蛋白和mRNA下降。敲低TRIM14后3种亚型乳腺癌细胞凋亡率上升,过表达TRIM14后3种亚型乳腺癌细胞凋亡率下降。3种亚型乳腺癌组织miR-363-5p与TRIM14表达呈负相关。 结论化疗药物诱导3种亚型乳腺癌细胞后miR-363-5p表达上升,miR-363-5p靶向抑制TRIM14表达,促进3种乳腺癌细胞系凋亡。     

Real world initial palliative treatment patterns and clinical outcomes in premenopausal patients with hormone receptor-positive,HER2-negative metastatic breast cancer: A study of the National Cancer Center,China

BackgroundTo observe whether guideline non-adherence in initial palliative treatment choices for premenopausal hormone receptor-positive (HR+), HER2-negative metastatic breast cancer (MBC) patients result in worse clinical outcomes in the Chinese population.MethodsThe China National Cancer Center database was used to identify 2194 patients diagnosed between 2004 and 2015. A total of 451 premenopausal patients with HR + HER2- MBC were included. Clinicopathological features and survival information were extracted. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method and compared using log-rank test.ResultsThe number of patients receiving initial chemotherapy, endocrine therapy and chemo-endocrine therapy were 222 (49.2%), 80 (17.7%), and 149 (33.0%), respectively. Patients receiving initial chemotherapy were more likely to be luminal B subtype, had more de novo stage IV disease and more liver metastasis, compared with patients receiving initial endocrine therapy. Both PFS and OS were significantly longer for chemo-endocrine therapy group (median PFS 18.9 months and OS 75.0 months), than for endocrine therapy group (median PFS 11.7 months and OS 53.5 months), and chemotherapy group (median PFS 7.1 months and OS 43.9 months). In multivariate analysis, none of the three treatment strategies were independently associated with PFS or OS.ConclusionIn real world, a high percentage of premenopausal patients with HR + HER2- disease received chemotherapy as initial palliative treatment in China, which was not associated with worsened survival. Further studies with larger sample size across China are needed to explore the relationship between this guideline non-adherence and clinical outcomes.     

中青年乳腺癌患者配偶夫妻疾病沟通现状及影响因素分析

目的 调查乳腺癌患者配偶夫妻疾病沟通现状及其影响因素,为临床开展针对性配偶或夫妻干预提供参考。方法 采用一般资料问卷、夫妻癌症沟通问题量表配偶部分、二元应对量表、洛克-华莱氏婚姻调适量表及癌症自我效能量表-配偶版对278名中青年乳腺癌患者配偶进行调查。结果 中青年乳腺癌患者配偶的夫妻疾病沟通问题总分为15.66±2.27,自我效能、二元应对、婚龄及累计照顾时长是中青年乳腺癌患者配偶夫妻疾病沟通问题的影响因素（均P<0.05）,可解释总变异的40.1%。结论 中青年乳腺癌患者配偶夫妻疾病沟通问题处于中等偏低水平,自我效能低、二元应对水平低、婚龄短及累计照顾时间短的配偶与患者间更易出现沟通问题。医护人员应重视婚龄短、照护时间较短的夫妻,可以自我效能及二元应对为切入点制订配偶及夫妻相关护理措施,改善夫妻疾病沟通问题。     

早期乳腺癌前哨淋巴结活检手术中示踪方法的临床应用研究

目的对比分析核素联合亚甲蓝与亚甲蓝单示踪法在早期乳腺癌前哨淋巴结活检术中应用效果。方法收集我院385例行前哨淋巴结活检术的乳腺癌患者的临床资料,其中109例由高年资医生应用亚甲蓝单示踪法,276例由高年资和低年资两组医生应用核素联合亚甲蓝示踪法,对比分析行联合示踪法与单示踪法前哨淋巴结活检结果的差异。并分析不同年资手术医生在联合示踪法前哨淋巴结活检结果的差异。结果联合示踪法与亚甲蓝单示踪法在前哨淋巴结活检的检出率、假阴性率、准确率、灵敏率无统计学意义(P>0.05),在联合示踪法下,高年资手术医生与低年资手术医生的前哨淋巴结活检的检出率、假阴性率、准确率无显著差异(P>0.05)。结论高年资外科医生使用亚甲蓝单示踪法行前哨淋巴结活检,是安全可靠又经济的方法。联合示踪法有助于帮助年轻的乳腺外科医生快速掌握熟悉前哨淋巴结活检技术。     

乳腺癌三苯氧胺耐药机制的研究进展

三苯氧胺作为一线药物应用于乳腺癌内分泌治疗已有多年,但长期应用后的耐药现象仍然是一个问题.本文拟通过回顾近年来有关乳腺癌三苯氧胺耐药机制的研究进展,为阐明三苯氧胺耐药机理及克服耐药性提供有价值的信息和思路.     

Feeding outcomes and influences within the neonatal unit

This study examined the feeding intention of mothers (n = 100), and the factors and beliefs, and changes in those factors or beliefs that influenced their choices, in the challenging environment of the neonatal unit. Mothers' experience and the frequency of nurse-assisted feeding activities were examined in mothers intending and not intending to breast-feed on discharge. Eighty-one per cent of mothers were either partially or fully breast-feeding or intending to do so on discharge. The most important factors identified as influencing this feeding choice included personal choice, with other influences being special benefits, more natural and feeling closer to the baby. Experiences such as infants receiving their first sucking feed from either the breast or bottle (inclusive of breast milk) and mothers expressing breast milk more frequently, were found to be significantly different and increased in frequency, in mothers intending to breast-feed. Differences in the mean weighted total daily nurse-assisted feeding score confirmed that these activities varied with gestational age (< or = 32 weeks [2.57], 32 to less than 35 weeks [3.86], and > or = 35 weeks [4.91]; F = 7.04, d.f. 55, P = 0.002), although there was insufficient power to determine differences between breast-feeding and non-breast-feeding mothers. The use of the Feeding Activities Calendar may have contributed to increased activity and high levels of breast-feeding in this preterm group.     

基于超声的影像组学应用于乳腺肿瘤进展

乳腺癌是威胁女性健康的常见恶性肿瘤。影像组学利用大数据及算法挖掘图像的微观定量特征,分析其与肿瘤性质、基因表达及预后等临床信息之间的关系。本文对基于超声的影像组学在乳腺肿瘤中的应用进展进行综述。     

Window of opportunity treatment in breast cancer

Window of opportunity therapies, which involve short‐term administration of systemic therapy between cancer diagnosis and surgery, have raised significant interest in recent years as a mean of assessing the sensitivity of a patient's cancer to therapy prior to surgery. There is now compelling evidence that in patients with early stage hormone‐receptor positive breast cancer, a 2‐week preoperative treatment with standard hormone therapies in a preoperative window period provides important prognostic information, which in turn helps to aid decision‐making regarding treatment options. Changes in short‐term biomarker endpoints such as cell proliferation measured by Ki‐67 can act as surrogate markers of long‐term outcomes. Paired tissues obtained pre‐ and post‐investigational treatment, without having to subject the patient to additional biopsies, can then be used to conduct translational research to investigate predictive biomarkers and pharmacodynamics. In this review, we will examine the utility and challenges of window of opportunities therapies in breast cancer in the current literature, and the current Australian and international trial landscape in this clinical space.